Predictors of long time survival after lung cancer surgery: a retrospective cohort study.
BACKGROUND
There have been few reports regarding long time survival after lung cancer surgery. The influence of age and pulmonary function on long time survival is still not fully discovered. Some reports suggest that hospitals with a high surgical volume have better results. The aim of this study was to evaluate lung cancer surgery performed in a county hospital in terms of 30 days mortality, complications and predictors of long time survival.


METHODS
All patients operated with non-small cell lung cancer in the period 1993-2006 were reviewed, and 148 patients were included in the study. 30 days mortality and complications were analyzed by univariate analysis. Kaplan Meier plots were performed to display some of the univariate variables. Cox regression analysis was performed to find Hazard Ratios (HR) that predicted long time survival in univariate and multivariate analysis.


RESULTS
The overall 30 days mortality rate was 2.7%, whereas 36.3% had one or more complications after surgery. The median survival time was 3.4 years. In multivariate Cox regression analysis advanced preoperative stage predicted reduced long time survival with HR (95%CI) 1.63 (0.92, 2.89) and 4.16 (1.92, 9.05) for patients in stage IB and II-IV respectively, when compared to patients in stage IA. Age >or= 70 years and FEV1<80% predicted reduced long time survival with HR (95%CI) 2.23 (1.41, 3.54) and 1.93 (1.14, 3.28) respectively, compared to age<70 years and FEV1 >or= 80%.


CONCLUSIONS
Thirty days mortality and complication rate showed that lung cancer surgery can be performed safely in a county hospital with experienced thoracic surgeons. Early preoperative stage, age below 70 years and normal pulmonary function predicted long time survival.
Roth
Kjetil
K
Department of Thoracic Medicine, Haukeland University Hospital, Bergen, Norway. kjetil.roth@med.uib.no
Nilsen
Tom Ivar Lund
TI
Hatlen
Elisabeth
E
Sørensen
Karina Søvik
KS
Hole
Torstein
T
Haaverstad
Rune
R
D000367:Age Factors; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality* / Q000473:pathology* / Q000503:physiopathology; D015331:Cohort Studies; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000503:physiopathology; D008297:Male; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D012044:Regression Analysis; D012189:Retrospective Studies; D017741:Survivors